Is there a relationship between Eustachian tube dysfunction and nasal septal deviation in a sample of the Lebanese population?

Background: The Eustachian tube (ET) is considered an organ by itself due to its specific functions. An ET Dysfunction (ETD) is discussed when this tube is unable to ventilate the middle ear properly. Clinically, the patient reports usually some aural fullness, "popping", "under water" sensation as if the ear is clogged. This condition is common affecting at least 5% of the adult population. It can impair quality of life and become disabling. On the other side, the prevalence of nasal septal deviation (NSD) is believed to be around 22.83% in the adult population. Nasal septal deviation is thought to cause a decline in the middle ear ventilation according to certain authors. The primary outcome is to define the predictive value of the side of Eustachian Tube Dysfunction (ETD) symptoms vis-à-vis the side of nasal septal deviation (NSD) in patients having the two conditions concomitantly.
Methods: A cross-sectional study was conducted between July 2018 and September 2019. Overall, 60 consecutive subjects (total of 120 ears), randomly seen at the Otorhinolaryngology Outpatient Clinics at the Eye and Ear International Hospital, Lebanon, all year-round were enrolled and tested without any geographic preferences. The Eustachian Tube Dysfunction Questionnaire (ETDQ) -7 questionnaire was used to evaluate ETD.
Results: A significantly higher ETD score was found in males compared to females, in those with left septal deviation compared to right and in those who have symptoms on the left compared to right side. Frequent exposure to higher changes in altitude (commute from home to workplace) was also significantly associated with higher ETD scores (r = 0.265), whereas higher Left Tympanometric peak pressure (TPP in daPa) on tympanometry was significantly associated with lower ETD score (r = - 0.467). Furthermore, 25 patients who had symptoms on the left side had also a septal deviation to the left side (86.2%), whereas 29 (93.5%) patients who had the symptoms on the right side had septal deviation to the right side (p < 0.001).
Conclusion: Our data highlighted the importance of altitude and geographic distribution of patients especially in a population exposed to barotrauma on a daily basis like the Lebanese population. Tympanometry, on the other hand, failed to correlate with patient reported symptoms and thus needs further evaluation. The reported ETD symptoms of the patient correlates to the side of NSD.